Added value of ultrafast sequence in abbreviated breast MRI surveillance in women with a personal history of breast cancer: A multireader study

医学 麦克内马尔试验 乳房磁振造影 乳腺癌 放射科 乳房成像 核医学 癌症 乳腺摄影术 内科学 统计 数学
作者
Eun Sil Kim,Nariya Cho,Soo‐Yeon Kim,Su Hyun Lee,Jung Min Chang,Yeon Soo Kim,Su Min Ha,Woo Kyung Moon
出处
期刊:European Journal of Radiology [Elsevier BV]
卷期号:151: 110322-110322 被引量:6
标识
DOI:10.1016/j.ejrad.2022.110322
摘要

Purpose To evaluate the added value of ultrafast MRI in abbreviated breast MRI (AB-MRI) surveillance in women with a personal history of breast cancer (PHBC). Method Between September 2017 and November 2019, consecutive postoperative surveillance AB-MRIs with ultrafast MRIs (20 images with a 4.0-second temporal resolution using 4D time-resolved angiography with keyhole technique) were retrospectively collected. Four blinded radiologists independently classified the Breast Imaging Reporting and Data System (BI-RADS) category for AB-MRI alone versus the combined protocol (AB-MRI + ultrafast MRI). Readers were recommended to change BI-RADS category according to the time to enhancement cut-off of 12 s in ultrafast MRI. McNemar test and generalized estimation equation model were used to compare the diagnostic performances. Results A total of 867 MRI examinations in 867 women (mean age ± standard deviation, 51 years ± 8) were evaluated. The sensitivity of both protocols among all readers was the same, at 90% (9/10). Addition of ultrafast MRI improved the specificity (a mean of 95.3% vs. 88.6 %, p < 0.001 for all readers) and positive predictive value 1 (PPV1) (a mean of 21% vs. 10%, p < 0.001 for all readers) compared to AB-MRI alone. Downgrading BI-RADS category 3 to 2 in four readers in a mean of 6.7% (57 of 857) of negative or benign findings was the main reason for the improved specificity and PPV1. Conclusion Addition of ultrafast MRI to AB-MRI improved the specificity and PPV1 by reducing unnecessary short-term follow-ups without compromising sensitivity in postoperative surveillance.
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